Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Foreword
- Part I Introduction
- Part II Diagnostic and Clinical aspects
- Part III Growth hormone replacement therapy in adults with growth hormone deficiency
- 8 The effect of growth hormone on protein metabolism
- 9 Growth hormone deficiency, insulin resistance and glucose metabolism
- 10 Growth hormone and body composition
- 11 Effects of growth hormone on human fluid homeostasis
- 12 Growth hormone and cardiac function
- 13 Growth hormone and cardiovascular risk factors
- 14 Growth hormone (GH), exercise performance, muscle strength and sweat production in healthy subjects and in adults with GH deficiency
- 15 Growth hormone and bone and mineral metabolism
- 16 Growth hormone and thyroid function and energy expenditure
- 17 Growth hormone and psychosocial and central nervous effects
- 18 Impact of gender and age on growth hormone responsiveness
- Part IV Growth hormone, growth-hormone releasing peptides and ageing
- Index
13 - Growth hormone and cardiovascular risk factors
from Part III - Growth hormone replacement therapy in adults with growth hormone deficiency
Published online by Cambridge University Press: 08 January 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Foreword
- Part I Introduction
- Part II Diagnostic and Clinical aspects
- Part III Growth hormone replacement therapy in adults with growth hormone deficiency
- 8 The effect of growth hormone on protein metabolism
- 9 Growth hormone deficiency, insulin resistance and glucose metabolism
- 10 Growth hormone and body composition
- 11 Effects of growth hormone on human fluid homeostasis
- 12 Growth hormone and cardiac function
- 13 Growth hormone and cardiovascular risk factors
- 14 Growth hormone (GH), exercise performance, muscle strength and sweat production in healthy subjects and in adults with GH deficiency
- 15 Growth hormone and bone and mineral metabolism
- 16 Growth hormone and thyroid function and energy expenditure
- 17 Growth hormone and psychosocial and central nervous effects
- 18 Impact of gender and age on growth hormone responsiveness
- Part IV Growth hormone, growth-hormone releasing peptides and ageing
- Index
Summary
Background
Growth hormone (GH) deficiency (GHD) in adults (GHDA) is now fully recognized as a specific clinical syndrome (Cuneo et al., 1992). Thus, this syndrome is associated with a decreased pychological well-being (McGauley et al., 1990; Rosén et al., 1994b), an abnormal body composition (Binnerts et al., 1992; Rosén et al., 1993a), reduced bone mineral content (Rosén et al., 1993c), with an increased fracture frequency (Rosén et al., 1997), impaired cardiac function (Shahi et al., 1991), and a decrease in exercise capacity (Cuneo et al., 1991). Furthermore, GHDA has been associated with a disturbed lipoprotein pattern (Rosén et al., 1993b), impaired glucose-homeostasis (Johansson, J.-O. et al., 1995) and fibrinolysis (Johansson J.-O. et al., 1994), and increased cardiovascular mortality (Rosén & Bengtsson, 1990).
This review will address the consequences of GHDA on cardiovascular risk factors and the effects of the following rhGH treatment.
Cardiovascular mortality
Untreated GHDA seems to be associated with a premature cardiovascular and cerebrovascular mortality. In a retrospective study of 333 patients with hypopituitarism on routine replacement therapy diagnosed between 1956 and 1987, there was a twofold increase in deaths from cardiovascular disease among patients compared with controls (Rosén & Bengtsson, 1990). No relationship was found between increased death rate and variables such as age at diagnosis, calendar year, sex, time before and after diagnosis, prevalence of hypertension or diabetes mellitus. In another retrospective cohort study from southern Sweden, 344 patients with hypopituitarism, diagnosed between 1952 and 1992, the cardiovascular mortality was likewise increased in patients compared with the control population (Bülow et al., 1997).
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- Growth Hormone in AdultsPhysiological and Clinical Aspects, pp. 265 - 280Publisher: Cambridge University PressPrint publication year: 2000
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